Hospital Name & Location: ___________________________

Department/Service Used: ___________________________

My Experience:
I visited this hospital for ___________________________. The doctors were ___________________________ (e.g., polite, knowledgeable, attentive). The nurses and staff were ___________________________ (e.g., caring, helpful, professional).

Facilities & Cleanliness:
The hospital was ___________________________ (e.g., clean, well-maintained, modern, lacking some facilities).

Waiting Time:
The waiting time was ___________________________ (e.g., short, reasonable, too long).

Cost & Payment:
The charges were ___________________________ (e.g., reasonable, expensive) and payment process was ___________________________ (e.g., smooth, difficult).

Positives:

Areas for Improvement:

Overall Rating: ★★★★☆ (change as per your experience)

Recommendation:
I would / would not recommend this hospital for ___________________________.